Provider Demographics
NPI:1295733749
Name:COLLIER, ARTHUR JONATHAN (PT,ATCLAT)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:JONATHAN
Last Name:COLLIER
Suffix:
Gender:M
Credentials:PT,ATCLAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 BLANDING BLVD
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5051
Mailing Address - Country:US
Mailing Address - Phone:904-276-7881
Mailing Address - Fax:904-276-7568
Practice Address - Street 1:410 BLANDING BLVD
Practice Address - Street 2:SUITE 6A
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5051
Practice Address - Country:US
Practice Address - Phone:904-276-7881
Practice Address - Fax:904-276-7568
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT1960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1374OtherMEDICARE GROUP NUMBER
FLY904KOtherBCBS PROVIDER
FLY904KOtherBCBS PROVIDER
FLK1374OtherMEDICARE GROUP NUMBER